Health care is a ‘people’ business, which means it can be fascinating, unpredictable, challenging and, at times, frightening.
People accessing health services and their families are often under great stress, which can make them behave unpredictably. Health care workers occasionally have to deal with people who are angry, aggressive, or even violent.
There are simple measures you can take to ensure you remain safe while carrying out your work. For instance, if you’re facing someone who’s being aggressive and perhaps shouting:
- maintain your respect for the person’s self-esteem and dignity
- don’t consider the aggression as being targeted at you personally
- adopt a non-aggressive stance and keep a good distance from the person, maintaining your own personal space
- remove, if you can, any potential hazards from the area and any immediate things that might be causing the person stress
- keep your voice at normal levels, even if the person is shouting
- be honest with the person – don’t try to mask your anxiety, but keep it controlled; you might say, for instance, ‘Your shouting is making me uncomfortable, Mr Smith, but I’m here because I want to help’
- try to get the person to explain what is troubling him or her (using the techniques we reviewed in communication methods)
- be assertive, but avoid getting into an argument with the person, even if you know what he or she is saying is wrong; focus on, and acknowledge, the reality of the person’s anger
- if you can, begin to offer some options that might resolve the situation – ‘Would it help if I … ?’
- if you work on your own (perhaps in a community setting), make sure your employer supplies you with adequate personal alarms and has a system to identify where you are at all times.
Sadly, a number of health care workers throughout the UK are assaulted by patients/clients or their carers every year. This is still a rare occurrence, but it’s important to emphasise that if it should happen to you, or if you feel you’ve been in a situation in which you’ve only narrowly escaped assault, you must report the incident to your manager or supervisor as soon as possible. This will help not only you, but also your fellow workers who may have to provide services for the person as well.
Follow Jane’s story in the activity below.
Jane arrives at the home of a new patient requiring a dressing change.
Her knock is answered by a young man holding a beer can and wobbling on his feet. He calls out, “Your nurse is here mate, right in the middle of the game but she’s cute!”
Four more young men stumble out from the front room. All appear to be affected by alcohol.
Jane nervously enters the house and asks her patient where she can attend to his dressing. He reluctantly leaves his friends in the front room and takes Jane to the kitchen where she provides his care.
When Jane tries to leave, she is surrounded by the young men who make suggestive comments, encouraging Jane to stay and drink with them. Jane feels very threatened and frightened. She manages to force her way to the front door and leaves the house.
..........and it was recorded in the young man’s file. His GP contacted him to complain about the incident and to insist that he attend the GP surgery for further dressings as he was not prepared for the community nurses to attend his house.
Jane reported the incident........
.........and when a colleague visited the house the following weekend to attend to the patient’s dressing she was assaulted by a group of alcohol-affected young men when she tried to leave. Because there was nothing in the patient's notes, she was unaware of the potential threat.
Jane didn't report the incident.......
The RCN has around 900 safety representatives working in a range of sectors. They play a valuable role in driving up health and safety standards in the workplace and in providing advice for members on how to retain their security while at work. For more information, see: The role of RCN safety reps.